澳大利亚全科医疗与儿童及家庭健康机构中幼儿肥胖预防的比较：一项混合方法研究。

A comparison of early childhood obesity prevention in Australian general practice and child and family health settings: A mixed methods study.

作者信息

House Eve T, Kerr Erin, Taki Sarah, Denney-Wilson Elizabeth, Baur Louise A, Cheng Heilok, Rossiter Chris, Vlahos Sharlene, Wen Li Ming

机构信息

The University of Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), Sydney, NSW, Australia; Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Sydney, NSW, Australia; Sydney Institute for Women, Children and Their Families, Sydney Local Health District, NSW Health, Sydney, NSW, Australia.

Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Sydney, NSW, Australia; Sydney Institute for Women, Children and Their Families, Sydney Local Health District, NSW Health, Sydney, NSW, Australia.

出版信息

J Pediatr Nurs. 2025 Mar-Apr;81:97-107. doi: 10.1016/j.pedn.2025.01.021. Epub 2025 Jan 30.

DOI:10.1016/j.pedn.2025.01.021

PMID:39889504

Abstract

OBJECTIVES

We aimed to 1) understand and compare the knowledge, self-efficacy, practices, and attitudes of primary health professionals (PHPs) in general practice and child and family health settings regarding early childhood health promotion and obesity prevention, and 2) describe barriers and facilitators to embedding preventive care in these settings.

METHODS

From August 2022 to July 2023, PHPs were recruited to participate in a mixed methods study, 227 PHPs completed a 20-item online survey and 28 participated in semi-structured interviews. Most were female, and almost half were Child and Family Health Nurses. Quantitative data were analysed descriptively, using Chi-squared or Fisher's exact tests to compare responses of Child and Family Health Nurses and PHPs in general practice. Reflexive thematic analysis of qualitative data was conducted.

RESULTS

Child and Family Health Nurses engaged in health promotion activities (including growth assessment, and discussions of infant feeding and childhood nutrition) more frequently and were more confident doing so than general practice professionals. The latter also agreed with more statements inconsistent with current health promotion recommendations and were less likely to report having sufficient time to discuss healthy lifestyle behaviours with families. At interview professionals considered health promotion and obesity prevention an important component of their role. Organisational barriers, including limited time and staffing challenges, limit opportunities for engagement in early childhood obesity prevention.

CONCLUSIONS

PHPs require support to implement preventive care guidelines in routine practice. Professional education accompanied by organisational changes are required to support implementation of obesity prevention strategies in primary healthcare.

IMPLICATIONS TO PRACTICE

There are many barriers to the implementation of early childhood obesity prevention in Australian primary healthcare. PHPs require training and resourcing to increase capacity to embed early childhood obesity prevention in their routine care.

摘要

目标

我们旨在：1）了解并比较普通全科医疗及儿童与家庭健康服务机构中的初级卫生保健专业人员（PHP）在幼儿健康促进和肥胖预防方面的知识、自我效能感、实践情况及态度；2）描述在这些机构中实施预防性保健的障碍和促进因素。

方法

2022年8月至2023年7月，招募PHP参与一项混合方法研究，227名PHP完成了一项包含20个项目的在线调查，28人参与了半结构化访谈。大多数为女性，近一半是儿童与家庭健康护士。对定量数据进行描述性分析，使用卡方检验或费舍尔精确检验比较儿童与家庭健康护士及普通全科医疗PHP的回答。对定性数据进行反思性主题分析。

结果

儿童与家庭健康护士比普通全科医疗专业人员更频繁地参与健康促进活动（包括生长评估以及关于婴儿喂养和儿童营养的讨论），并且在这方面更有信心。后者也认同更多与当前健康促进建议不一致的陈述，并且不太可能报告有足够时间与家庭讨论健康生活方式行为。在访谈中，专业人员认为健康促进和肥胖预防是其职责的重要组成部分。组织障碍，包括时间有限和人员配备挑战，限制了参与幼儿肥胖预防的机会。